"CHICAGO — Younger people are making up a growing percentage of new coronavirus cases in cities and states where the virus is now surging, a trend that has alarmed public health officials and prompted renewed pleas for masks and social distancing.
In Arizona, where drive-up sites are overwhelmed by people seeking coronavirus tests, people ages 20 to 44 account for nearly half of all cases. In Florida, which breaks records for new cases nearly every day, the median age of residents testing positive for the virus has dropped to 35, down from 65 in March.
And in Texas, where the governor paused the reopening process on Thursday as hospitals grow increasingly crowded, young people now account for the majority of new cases in several urban centers. In Cameron County, which includes Brownsville and the tourist town of South Padre Island, people under 40 make up more than half of newly reported cases.
“What is clear is that the proportion of people who are younger appears to have dramatically changed,” said Joseph McCormick, a professor of epidemiology at UTHealth School of Public Health in Brownsville. “It’s really quite disturbing.”
The pattern is drawing notice from mayors, governors and public health officials, and comes as a worrisome sign for cities and institutions as they look to the fall. The rise in cases among younger people could complicate the plans of leaders who are eager to open schools and universities, resume athletic events and return to normal life and a fully functioning economy.
The increases could reflect a simple reality: Since many states have reopened bars, restaurants and offices, the coronavirus has been allowed to spread more widely across communities, including to more young people. But people in their 20s and 30s are also more likely to go out socializing, experts say, raising concerns that asymptomatic young people are helping to spread the virus to more vulnerable Americans at a time when cases are surging dangerously in the South and the West.
Dr. Robert Redfield, the director of the Centers for Disease Control and Prevention, said on Thursday that younger people have helped fuel the increase in known coronavirus infections — and that in the past, many of those infections went undiagnosed.
“Our best estimate right now is that for every case that was reported, there actually were 10 other infections,” he said.
No single answer fully accounts for the surge of cases among young people, who are less likely to be hospitalized or die from the coronavirus than older people.
“Is it the governor’s reopening? Is it Memorial Day? Is it the George Floyd demonstrations? Is it going to the beach?” said Eric Boerwinkle, dean of the UTHealth School of Public Health in Houston. “We don’t really know, but it is probably all of those things that are contributing.”
The United States recorded 36,975 new cases on Wednesday, a new high point in daily cases as the country confronted a new stage of the crisis two months after the previous high in late April. The resurgence is most immediately threatening states that reopened relatively early in the South and the West. Alabama, Florida, Oklahoma, South Carolina and Texas all reported their highest single-day totals this week, as did Montana and Utah, and cases were rising in 29 states on Thursday.
Adriana Carter, 21, is among the newly infected.
TWO STATES, DIFFERENT OUTCOMES With infections surging in Florida while they retreat in New York, the two states and their governors reflect the shifting course of the pandemic.
For many weeks this spring, she said, she took steps to limit her exposure, eating many of her meals at her apartment in San Marcos, Texas, and wearing a mask when going in and out of stores. At the one Black Lives Matter protest she attended, most people were in masks.
But after a particularly long week of juggling online summer classes and her job at an eye clinic, Ms. Carter took a risk one Saturday night in early June and met a friend at the Square, a popular bar district downtown. Though they were careful to avoid the most crowded spots, they chose not to wear masks as they sipped drinks inside and endured the hot Texas weather.
Days later, her friend woke up feeling ill. Both tested positive for the virus.
“We were told we could go out to bars,” she said, adding that she had been careful to quarantine since she learned that she had been exposed. “It’s very unusual for anyone in their 20s to stay at home all the time — not giving any excuses or anything, but I just think we are all just trying to do the best we can.”
The new cases among young people may appear to be a departure from the early days of the pandemic when infections in nursing homes were spiraling out of control, and the virus appeared at higher rates among older people in New York City.
Experts cautioned that the seemingly new prevalence among young people may be, in part, a reflection of more widely available testing. But the growing numbers of people hospitalized in states like North Carolina and Texas also suggest increased transmission of the virus.
Even now, people younger than 50 are being hospitalized at a far lower rate than people older than that, according to C.D.C. data.
While the effect of the coronavirus on younger people “may not be highly associated with hospitalization and death,” Dr. Redfield said, “they do act as a transmission connector for individuals that could in fact be at a higher risk.”
In Florida, which has emerged as a particularly concerning hot spot, reopened bars have been a source of contagion among young people. The state shut down the Knight’s Pub, a popular bar near the University of Central Florida in Orlando, after 28 patrons and 13 employees were infected.
In Miami-Dade County, the number of known coronavirus cases among 18- to 34-year-olds increased fivefold in a month, to more than 1,000, Mayor Carlos Gimenez said this week.
“They’re thinking they’re invincible,” he said, adding that many of the infected have no symptoms. They are at higher risk, though, if they are overweight or have diabetes or other medical conditions, he said. About a third of the coronavirus patients at the public Jackson Health System were from that age group, and about half had a high body mass index, Mr. Gimenez said.
Gov. Ron DeSantis described “a real explosion in new cases” among younger people. “Part of that is just natural,” he said. “You kind of go and you want to be doing things. You want to be out and about. The folks who are older and would be more vulnerable are being a bit more careful.”
In fact, some experts believe that a decision by older people to stay home and exercise caution to avoid the virus may, in part, help explain why young people appear to be an increasing portion of new cases.
Frequently Asked Questions and Advice Updated June 30, 2020
What are the symptoms of coronavirus? Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
What’s the best material for a mask? Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
Is it harder to exercise while wearing a mask? A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
I’ve heard about a treatment called dexamethasone. Does it work? The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
What is pandemic paid leave? The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
Does asymptomatic transmission of Covid-19 happen? So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
What’s the risk of catching coronavirus from a surface? Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
How does blood type influence coronavirus? A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
How many people have lost their jobs due to coronavirus in the U.S.? The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
How can I protect myself while flying? If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
What should I do if I feel sick? If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
At the same time, older people have begun to represent a smaller portion of the total number of people who test positive for the virus. In June, people over 65 have made up 8 percent of new confirmed cases in Dallas County, down from 16 percent in March.
The situation is particularly unsettling in Hays County, home to Texas State University in San Marcos. Coronavirus cases have surged since the beginning of June, to 2,100 this week, from 371 at the start of the month. People in their 20s now make up more than half of all known cases, officials said.
In Arizona, rising infections have set many people on edge, including some residents in their 20s and 30s.
In the Arcadia neighborhood of Phoenix, Ian Bartczak, who is 31, said he did not feel comfortable dining out at restaurants and was dismayed to see crowds of young people squeezing onto patios and bars on a commercial strip near his home.
“It goes back to, what is a want and what is a need?” said Mr. Bartczak, who works for an education technology company. “Did you have to go to a big swimming party or El Hefe nightclub with your friends?”
His point of view has created awkwardness with some friends, he said. He has turned down invitations to go out for sushi, and been puzzled by friends who chose to visit casinos.
“It’s affected some of my relationships because I won’t see them or get kind of angry,” he said. “How are you not willing to help the old lady behind you who could have a poor immune system? Or help lower our cases so we can increase our economy?”
In Phoenix, Michael Donoghue, an investment analyst who is 33, said he felt comfortable going out — carefully — since he is single and healthy, lives alone and takes care to avoid close contact with people who might be at risk, like his 91-year-old grandmother.
Only once since restrictions were lifted in that state has he felt uncomfortable while out, he said. A bar he visited with friends in Scottsdale was crowded.
“It just felt like, should we be doing this right now?” he said.
The resurgence of the virus has echoes of its earliest days in the United States, as places like California and Washington State, which saw some of the country’s first outbreaks, were seeing new upticks.
In King County, Wash., which includes Seattle, people in their 20s and 30s make up about 45 percent of new coronavirus cases — a number that was 25 percent in March, according to Dr. Judith A. Malmgren, an epidemiologist in Seattle.
She believes the real percentage is even larger than what is being measured because younger people are less likely to be symptomatic. That said, she warned that the risk of infecting other people was serious. “Just because you’re in an age group that is less likely to die from coronavirus,” she said, “does not mean that you live alone.”
Julie Bosman reported from Chicago, and Sarah Mervosh from Pittsburgh. Patricia Mazzei contributed reporting from Miami, and Mitch Smith from Chicago." -The New York Times